Cardiovascular Disease and Cardiac Imaging in Inflammatory Arthritis

Area of Science:

• Rheumatology
• Cardiology
• Immunology

Background:

• Inflammatory arthritis (IA) is linked to increased cardiovascular morbidity and mortality compared to the general population.
• Established European League Against Rheumatism (EULAR) guidelines address cardiovascular disease (CVD) risk management in IA.
• Emerging evidence necessitates ongoing updates to CVD risk management strategies in IA.

Purpose of the Study:

• To review current evidence on cardiovascular disease in inflammatory arthritis, specifically rheumatoid arthritis, psoriatic arthritis, and axial spondylarthritis.
• To assess the scale of the cardiovascular problem in IA patients.
• To evaluate the role of imaging modalities in identifying cardiovascular disease in IA.

Main Methods:

• Literature review focusing on cardiovascular disease in rheumatoid arthritis, psoriatic arthritis, and axial spondylarthritis.
• Analysis of evidence regarding traditional cardiovascular risk factors and inflammation's contribution to CVD burden in IA.
• Evaluation of non-invasive cardiovascular imaging techniques for early detection of cardiovascular lesions in IA.

Main Results:

• Both traditional cardiovascular risk factors and systemic inflammation contribute significantly to the elevated CVD burden in IA.
• While newer treatments have reduced CVD incidence, it remains a critical comorbidity.
• Non-invasive cardiovascular imaging shows promise for accurate and prompt detection of cardiovascular lesions, even pre-clinically.

Conclusions:

• Cardiovascular disease remains a significant comorbidity in inflammatory arthritis, requiring vigilant screening and management.
• Integrated approaches involving rheumatologists and cardiologists are essential for optimal patient care.
• Non-invasive cardiovascular imaging offers a valuable tool for early detection and management of CVD in IA patients.